Periodontal (gum) disease, a bacterial infection caused by plaque, is one of the most prevalent and destructive dental conditions. Left untreated it can eventually lead to tooth and bone loss.

Although people are often unaware they have gum disease, there are a few warning signs to look for. Here are five gum disease signs that should prompt a dental visit.

Gum Swelling and Redness. Like all infections, gum disease triggers an immune system response that releases antibodies into the gums to attack the bacteria. The ensuing battle results in inflammation (swelling) and a darker redness to the gum tissues that don’t lessen with time.

Gum Bleeding. It isn’t normal for healthy gum tissue, which are quite resilient, to bleed. In a few cases, bleeding may indicate over-aggressive brushing, but more likely it means the tissues have weakened to such an extent by infection they bleed easily.

Tooth Sensitivity. If you notice a shot of pain when you eat or drink something hot or cold or when you bite down, this could mean infected gums have “drawn back” (receded) from the teeth. Gum recession exposes the tooth roots, which are more sensitive to temperature and pressure changes in the mouth.

An Abscess. As weakened gum tissues detach from the tooth, the normally thin gap between them and the tooth deepens to form a void known as a periodontal pocket. This often results in an abscess where pus collects in the pocket and causes it to appear more swollen and red than nearby tissues. An abscess needs immediate attention as bone loss is greatly accelerated compared to normal gum disease.

Tooth Looseness or Movement. As diseased gum tissue causes loss of gum and bone attachment, the affected teeth will start to feel loose or even move to a different position. This is a late and alarming sign of gum disease — without immediate intervention, you’re in danger of losing the tooth.

If you encounter any of these signs, contact us for an examination as soon as possible. The sooner we can diagnose gum disease and begin treatment, the less damage it will cause — and the better your odds of regaining healthy teeth and gums.

Pregnancy is a very special and exciting time for expectant women and their families. At this time, many moms-to-be make careful choices to try and do what’s best for themselves and their babies. Wondering what’s the right way to take care of your oral health when you’re expecting? Here are answers to a few of the most common questions about dental care during pregnancy.

Q: Does pregnancy make a woman more susceptible to dental problems?
A: Yes. Pregnancy causes big changes in the levels of certain hormones, and these in turn have a powerful influence on your body. For example, many expectant moms experience food cravings and morning sickness at certain times. Changing hormone levels can also affect your oral health in various ways, including making your gums tender, swollen, and highly sensitive to the harmful bacteria in plaque.

Q: What are “pregnancy tumors” in the mouth?
A: These are benign (non-cancerous) overgrowths of tissue that sometimes develop on the gums during the second trimester. Often appearing between the teeth, these swollen reddish growths are thought to be caused by plaque bacteria. They sometimes go away on their own when pregnancy is over, but may be surgically removed if they don’t.

Q: Is it normal to have bleeding gums during pregnancy?
A: It’s not uncommon, but it does indicate that you need to pay careful attention to your oral hygiene at this time. Pregnancy hormones can cause the tiny blood vessels in your gums to become enlarged; when plaque bacteria are not effectively removed from the mouth, the gums may become inflamed and begin to bleed. This condition is often called “pregnancy gingivitis.” If left untreated, it can progress to a more serious form of gum disease called periodontitis. That’s one reason why regular brushing and flossing are so important during pregnancy — as are routine professional cleanings.

Q: Is it safe to have dental cleanings and checkups during pregnancy?
A: Yes; in fact, it’s a very good idea to have at least one. Studies have shown that women who receive dental treatment during pregnancy face no more risks to their developing babies than those who don’t. On the other hand, poor oral health is known to cause gum disease, and is also suspected of being linked to adverse pregnancy outcomes. Routine dental exams and professional cleanings can help you maintain good oral health and avoid many potential problems during this critical time.

Q: Should I postpone more complicated dental work until after I have a baby?
A: It depends. A study recently published in the Journal of the American Dental Association found it was safe for pregnant women to have routine procedures like fillings, root canals, and extractions, even if they require local anesthesia. So treatments that are essential to an expectant mother’s health shouldn’t be put off. However, if you’re planning to have cosmetic dental work, it might be best to err on the side of caution and wait until after your baby is born.

Have more questions about oral health during pregnancy? Contact our office or schedule a consultation — and be sure to let us know that you are pregnant, so we can make sure you get the extra attention you need. You can learn more in the Dear Doctor magazine article “Pregnancy and Oral Health.”

Your gums not only support and protect your teeth they also help present them in a visually attractive way. But some people’s gums seem to stand out too much — what’s commonly called a gummy smile — which diminishes their smile appeal. There’s no precise definition, but as a rule of thumb we consider a smile too gummy if four or more millimeters (about an eighth of an inch) of the gums show.

Fortunately, there are some techniques to improve a gummy smile. Which technique is best for you, though, will depend on why the gums are prominent — and causes vary. For example, you could have a gummy smile because your teeth appear too short compared to your gums.

Permanent teeth normally erupt to about 10 mm of visible length. But less than that, say 8 mm, could skew the visible proportion of gums to teeth too much toward the gums. Teeth can also appear shorter due to accelerated wear caused by grinding habits. Another cause could be the amount of upper lip rise when you smile. The lip may rise too high in a condition called hypermobility. This could reveal too much of the gums when you smile.

It’s important then to match the treatment to the cause. For example, we can enhance the appearance of shorter teeth through a surgical procedure known as crown lengthening.Â During this procedure a surgeon reshapes the gum tissues and underlying bone to expose more of the tooth’s length.

For upper lip hypermobility, we can restrict movement with Botox, a drug that paralyzes tiny parts of the involved muscles. This approach, though, will wear off in a few months — a more permanent solution is surgery to reposition the muscle attachments so as to prevent excessive movement.

If you’re concerned about a gummy smile, see us for a full examination and consultation. Once we know the reason why, we can offer a solution that will make your smile more attractive.

If you would like more information on enhancing the appearance of your gums, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Gummy Smiles.”

Are bleeding gums something you should be concerned about? Dear Doctor magazine recently posed that question to Dr. Travis Stork, an emergency room physician and host of the syndicated TV show The Doctors. He answered with two questions of his own: “If you started bleeding from your eyeball, would you seek medical attention?” Needless to say, most everyone would. “So,” he asked, “why is it that when we bleed all the time when we floss that we think it’s no big deal?” As it turns out, that’s an excellent question — and one that’s often misunderstood.

First of all, let’s clarify what we mean by “bleeding all the time.” As many as 90 percent of people occasionally experience bleeding gums when they clean their teeth — particularly if they don’t do it often, or are just starting a flossing routine. But if your gums bleed regularly when you brush or floss, it almost certainly means there’s a problem. Many think bleeding gums is a sign they are brushing too hard; this is possible, but unlikely. It’s much more probable that irritated and bleeding gums are a sign of periodontal (gum) disease.

How common is this malady? According to the U.S. Centers for Disease Control, nearly half of allÂ Americans over age 30 have mild, moderate or severe gum disease — and that number increases to 70.1 percent for those over 65! Periodontal disease can occur when a bacteria-rich biofilm in the mouth (also called plaque) is allowed to build up on tooth and gum surfaces. Plaque causes the gums to become inflamed, as the immune system responds to the bacteria. Eventually, this can cause gum tissue to pull away from the teeth, forming bacteria-filled “pockets” under the gum surface. If left untreated, it can lead to more serious infection, and even tooth loss.

What should you do if your gums bleed regularly when brushing or flossing? The first step is to come in for a thorough examination. In combination with a regular oral exam (and possibly x-rays or other diagnostic tests), a simple (and painless) instrument called a periodontal probe can be used to determine how far any periodontal disease may have progressed. Armed with this information, we can determine the most effective way to fight the battle against gum disease.

Above all, don’t wait too long to come in for an exam! As Dr. Stork notes, bleeding gums are “a sign that things aren’t quite right.” Â If you would like more information about bleeding gums, please contact us or schedule an appointment. You can read more in the Dear Doctor magazine article “Bleeding Gums.” You can read the entire interview with Dr. Travis Stork in Dear Doctor magazine.

Question: What oral health issue do teenagers who wear orthodontic retainers and older folks who wear dentures have in common?

Answer: Both need to pay particular attention to cleaning their oral appliances.

The same goes for anyone who wears a nightguard to control tooth grinding, a mouthguard to protect teeth while playing sports, or a clear aligner for orthodontic treatment. Yet many people aren’t sure how to properly clean their appliances — so here are a few handy tips:

DON’T:

Use toothpaste on your appliance — the ingredients in toothpaste, which are designed to polish the hard enamel of your teeth, are too abrasive for the soft plastic of oral appliances, and will cause scratches.

Boil your appliance, or use bleach to clean it — both will end up breaking down and destroying the appliance. Don’t even use very hot water, as it can deform the plastic and make the appliance useless.

Leave your appliance out on the nightstand, or anywhere else — pets and small children have been known to find (and destroy) oral appliances left lying around. Instead, store it properly in its special case.

DO:

Use liquid dish detergent or hand soap to clean your appliance. A little mild soap plus warm water will do a great cleaning job. While you’re at it, get a brush just for the appliance — because, while it’s fine for plastic, you don’t want to brush your teeth with soap!

Put a towel in the sink basin when you clean your appliance. Soapy appliances (especially dentures) can be slippery, and can be damaged by dropping — and that’s an expensive mishap.

Consider investing in an ultrasonic cleaner. These inexpensive countertop devices are an excellent way to get the tiny ridges and crevices of your appliance really clean.

Whether you rely on dentures for everyday use, or just need to wear a retainer for a period of time, your oral appliance serves an important function. It may also represent a significant investment. That’s why it’s worthwhile to spend a few minutes each day giving these important items the care they need.

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